Provider Demographics
NPI:1427560150
Name:MARTINEZ TUERO, MAIKEL
Entity Type:Individual
Prefix:
First Name:MAIKEL
Middle Name:
Last Name:MARTINEZ TUERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 NW 55TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-2924
Mailing Address - Country:US
Mailing Address - Phone:305-898-9912
Mailing Address - Fax:
Practice Address - Street 1:2460 NW 55TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-2924
Practice Address - Country:US
Practice Address - Phone:305-898-9912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician